Many parents feel anxious about bringing their child for allergy testing. As a Consultant Paediatrician with a special interest in allergy, I want to reassure you that allergy appointments are straightforward, and most children find them much less daunting than they expect. This article walks you through what to expect at an allergy appointment at Belfast Children's Allergy Clinic.
Before the Appointment
Before your child's appointment, there are a few things to be aware of:
- Antihistamines: If your child takes antihistamines (e.g. cetirizine, loratadine, chlorphenamine), these should be stopped at least 3–5 days before skin prick testing, as they can suppress the skin reaction and give a false negative result. Please check with me if you are unsure.
- Topical steroids: Topical steroids applied to the test site (usually the forearm) should be avoided for a few days before testing.
- Food diary: It can be helpful to bring a food diary or a written record of your child's reactions, including what was eaten, when the reaction occurred, and what symptoms developed.
- What to bring: Any previous allergy test results, letters from other doctors, and a list of current medications.
The Consultation
The appointment begins with a detailed consultation. I will ask about:
- Your child's symptoms and any reactions they have had
- The timing and pattern of reactions
- Your child's diet and any foods that have been avoided
- Your child's medical history, including eczema, asthma and hay fever
- Family history of allergy
- Current medications
This history is the most important part of the assessment. Allergy test results must always be interpreted in the context of the clinical history.
Skin Prick Testing
If skin prick testing is appropriate, it is usually performed on the forearm. A small drop of allergen extract is placed on the skin, and a small lancet is used to introduce it just below the surface. This feels like a light scratch — not a needle injection. Multiple allergens can be tested at the same time.
After 15–20 minutes, I will measure any skin reactions (wheals) that have developed. A positive result produces a small raised bump, similar to a mosquito bite. The size of the wheal helps to guide interpretation, but must always be considered alongside the clinical history.
Most children tolerate skin prick testing very well. Younger children may need a little distraction during the test — bringing a favourite toy or snack can help.
Blood Testing
In some cases, a blood test for specific IgE antibodies may be recommended instead of, or in addition to, skin prick testing. This involves a small blood sample, usually taken from a vein in the arm. Results are typically available within a few days.
After the Tests
Once the tests are complete, I will discuss the results with you and explain what they mean for your child. I will provide:
- A clear explanation of the diagnosis
- A personalised management plan
- Written emergency action plan if needed
- Prescription of adrenaline auto-injectors if indicated
- Dietary advice and referral to a dietician if needed
- A follow-up plan
How Long Does an Appointment Take?
A first allergy appointment typically takes 45–60 minutes. This allows time for a thorough consultation, skin prick testing and a full discussion of results and management.
See also: Food Allergy Assessment in Children | Frequently Asked Questions
Dr Mugilan Anandarajan, Consultant Paediatrician (FRCPCH, MD). Also see: belfastallergyclinic.com | belfastchildrensclinic.com